MEDICARE: MS. REBECCA OLMSTED MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	52271	CA

General Provider Information

NPI Number	:	1992945133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA OLMSTED MA

Provider Business Mailing Address
First Line	:	5845 COLLEGE AVE
Second Line	:	SUITE 2
City	:	OAKLAND
State	:	CA
Zip	:	94618-1635
Country	:	US
Telephone Number	:	510-863-4795
Fax Number	:

Provider Business Practice Location Address
First Line	:	5845 COLLEGE AVE
Second Line	:	SUITE 2
City	:	OAKLAND
State	:	CA
Zip	:	94618-1635
Country	:	US
Telephone Number	:	510-863-4795
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2009
Last Update Date	:	03/24/2016

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